THE CORRELATION BETWEEN OSTEOPOROSIS AND CALCIUM INTAKE
AMONG 50 YEARS OLD WOMEN IN WEST JAKARTA IN 2008
UNIVERSITY OF TRISAKTI, JAKARTA
NAME : MOHD ASHAF BIN AMAT KHAINAN NIM : 03007299
PREFACE AND ACKNOWLEDGMENT
Alhamdulillah. Thanks to God, that has given me a chance to finish my work. Maybe its not the first time I need to make my own paper about any topic. So,this is a good time to learn something from the topics,about osteoporosis and calsium intake ans also its relationship between each other. In the aother hand, thia task make me understand to learn from any source around me and my effort to finish the task. First of all, I would like to thanks especially Mr. Husni nd Mdm. Fatmi that have given me this kind of opportunity to make my own paper. Also, to all my friends, for their support and encouragement that they have provided. In creating this kind of paper, it is important to achieve a happy medium between complexity and simplication. I need to come out everything I know about the topics and need to search every source especially through the internet, the main source for seeking the information. Finally, I hope that everyone will find all the information that I have gathered in this paper and I do wonder what their comments might have been abut this paper. So, I hope you will enjoy reading my paper and understand the important of knwoledge. Thank you.
Mohd Ashaf Bin Amat Khainan.
Preface and acknwoledgement i. ii. iii. Introduction Background Problems Limitations of problems Objective Methode of writing Frame of writing Part 1 : Osteoporosis Definitions Etiology Epidemiology Symptoms Factors Complications Diagnosis Treatment and medication Preventions Part 3 : Calcium Intake Calcium : what it is? What is the recommended intake for calcium? What Are the Important Cofactors for Achieving Optimal Calcium Intake? iv. v. vi. What foods provide calcium? Part 4: Correlation between osteoporosis and calcium intake Part 5: Conclusion Bibliography 21-22 22-24 25-28 29 30 19 19-21 8 9 10-11 11 12 13 13 14-15 16-18 4-7
also called bone tissue. The exact amount of calcium you need depends on your age and other factors. meaning it resists pushing forces well. Calcium has many important jobs. yet strong and hard. They function to move.
Bones are rigid organs that form part of the endoskeleton of vertebrates. Foods rich in calcium include diary products such as milk. It is important to get plenty of calcium in the foods you eat. formed mostly of calcium phosphate in the chemical arrangement termed calcium hydroxylapatite (this is the osseous tissue that gives bones their rigidity). You have more calcium in your body than any other mineral. nerves. One of the types of tissues that makes up bone is the mineralized osseous tissue. cheese and yogurt. People who do not eat enough high-calcium foods should take a calcium supplement. endosteum and periosteum. The rest is throughout the body in blood. There are 206 bones in the adult human body. blood vessels and cartilage.PART 1 : Introduction
1) Background. in addition to fulfilling their many other functions. Your body needs calcium to help muscles and blood vessels contract and expand. Growing children and teenagers need more calcium than young adults. produce red and white blood cells and store minerals. that gives it rigidity and honeycomb-like three-dimensional internal structure.
. but not pulling forces. Older women need plenty of calcium to prevent osteoporosis. they are lightweight. osseous tissue. muscle and the fluid between cells. contributed chiefly by collagen. is a relatively hard and lightweight composite material. green vegetables. it does have a significant degree of elasticity. and leafy. The body stores more than 99 percent of its calcium in the bones and teeth to help make and keep them strong. and protect the various organs of the body. to secrete hormones and enzymes and to send messages through the nervous system. For the calcium. While bone is essentially brittle. Other types of tissue found in bones include marrow. It has relatively high compressive strength but poor tensile strength. Because bones come in a variety of shapes and have a complex internal and external structure. support. The primary tissue of bone. All bones consist of living cells embedded in the mineralized organic matrix that makes up the osseous tissue.
After about age 20. They are living tissues that rebuild constantly throughout your life. give you shape and support your body. IV. and to prevent bone loss when you are older. Your bones help you move. I will be discuss the topics according to a few aspects: I. VII. Futhermore. II. you need to get enough calcium. III. For this paper. VIII. During childhood and your teens. There are many kinds of bone problems: Osteoporosis makes your bones weak and more likely to break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bone disease can make bones easy to break Bones can also develop cancer Other bone diseases are caused by poor nutrition. you can lose bone faster than you make bone. IX. vitamin D and exercise. VI. In this paper .2) Problems. the bones disease that will be discuss are about osteoporosis and its correlatin with calcium intake among 50 years old women in West Jakarta in 2008 3) Limitation of problems. genetic factors or problems with the rate of bone growth or rebuilding So. the structure of the bones somehow are connected with the calcium intake. To have strong bones when you are young. What is the definition? What is the etiology? What is the epidemiology? What are the symptoms? What are the factors? What are the complications? How to diagnose? What are the treatments and medications? What are the preventions?
. your body adds new bone faster than it removes old bone. V. osteoporosis. it related to one of the bones disease.
rewrite and choose the best informations that related to the topics. one of the silent disease especially among women after menapouse and the effects of calcium intake towards the disease. people will more understand the real situation about the disease and how to protect themselves from being infected.4) Objective. The main objective is to reveal the correlation and relationship between osteoporosis and calcium intake. Furthemore. The method that being used in this paper are searched and gathered all the information from the internet. The informations that have been choosed will be put according its subtopics and the paper structures.
5) Method of writing.
. So that. the other objectives are to know facts about osteoporosis.
6) Frame of writing Preface and acknolegment Part 1 : Introduction Background Problems Limitation of problems Objective Methode of writing Frame of writing
Part 2: Osteoporosis Definition Etiology Epidemiology Symptoms Factors Diagnosis Treatment and medication preventions
Part 3 : Calcium Intake Part 4 : Correlations Between Osteoporosis and Calcium Intake Part 5 : Conclusion
also known as fractures.
A condition characterized by the loss of the normal density of bone. occur typically in the hip.
. These broken bones. The fracture can be either in the form of cracking (as in a hip fracture). collagen. Osteoporosis leads to literally abnormally porous bone that is more compressible like a sponge. Definition
A disease in which bones become fragile and more likely to break. although osteoporosis-related fractures can also occur in almost any skeletal bone. and wrist.PART 2 : OSTEOPOROSIS
a. and calcium all of which give bone its strength. or collapsing (as in a compression fracture of the vertebrae of the spine).
Normal bone is composed of protein. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone fracture. This disorder of the skeleton weakens the bone causing an increase in the risk for breaking bones (bone fracture). The spine. osteoporosis can progress painlessly until a bone breaks. resulting in fragile bone. spine. than dense like a brick. If not prevented or if left untreated. hips. and wrists are common areas of bone fractures from osteoporosis.
suboptimal calcium and vitamin D nutrition. and vertebrae. fat. The consequence is a loss of cortical and trabecular bone and increased risk for fractures of the hip. Susan Brown of the Osteoporosis Education Project. or other conditions that cause increased bone loss by various mechanisms. and lack of exercise.
Osteoporosis occurs secondary to medications. in spite of massive efforts over several decades. maladaptation to stress (distress-induced excess cortisol and adrenaline).
According to Dr.b.
. immune hypersensitivity (delayed allergy) reactions
Osteoporosis occurs in women and men because of decreased formation of bone and decreased renal production of 1. Etiology
The accepted etiology of osteoporosis is related to sex hormone deficiency in menopause and andropause.25(OH)2 D3 occurring late in life. phosphate/phosphoric acid and sulfate/sulfuric acid). The mechanisms through which hormone deficiency facilitates bone osteoporosis remain controversial. She holds that the excess acid load promoting metabolic acidosis is acquired by: dietary choices (excess protein. which robs us of our mineral reserves and impairs efforts to rebuild the bone matrix. osteoporosis can be seen as a consequence of chronic metabolic acidosis. especially glucocorticoids. osteoporosis continues to remain an enormous clinical problem. long bones. However.
000 hip fractures. Using this cutoff.646 men and women ages 20 and older in the full survey over the 6-year period. 250.000 wrist fractures [Riggs and Melton. The population of men and women was categorized into three ethnic groups: nonhispanic white (NHW).c. Moreover. provided estimates of the number of women ages 50 and older with osteoporosis (BMD more than 2 SD below the young adult mean). using a different cutoff for the definition of osteoporosis. The major clinical consequence of osteoporosis is a greatly increased risk of fracture. more than 28 million people are affected. and Mexican American (MA).
. nearly 16 million women and 3 million men have osteopenia and are at increased risk for developing osteoporosis and osteoporotic fracture.000 vertebral fractures. 1995])
NHANES III was a 6-year study (1988-1994) divided into two phases: Phase 1 (1988-1991) and Phase 2 (1991-1994). the National Osteoporosis Foundation (NOF) estimated that about 8 million women and 2 million men have osteoporosis.
Using data from Phases 1 and 2 of NHANES III.
Another analysis of NHANES III Phase 1 data.
Using data from Phase 1 of NHANES III. Epidemiology
In the United States. 14 million women in the United States have osteoporosis and an additional 12 million have low bone mass. Bone mineral measurements were performed on 14.
Estimates of the number of older men and women (ages 50 and older) in the United States with low bone density at the hip (osteopenia and osteoporosis) were made using dual energy X-ray absorptiometry (DXA) measurements gathered in both Phases 1 and 2 of NHANES III. and 250.5 million fractures yearly (including 700. Osteoporosis predisposes the population to 1. nonhispanic black (NHB). the NOF published in the Physician’s Guide to Prevention and Treatment of Osteoporosis that 13-18% (4-6 million) of postmenopausal American women have osteoporosis and an additional 37-50% (13-17 million) of women have low bone density at the hip.
The highest incidence is found among those men and women ages 80 or older [Melton et al... once a person has experienced a spine fracture due to osteoporosis. Symptoms The osteoporosis condition can be present without any symptoms for decades..-
In the United States. Elderly patients can further develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after a hip fracture. Some osteoporosis fractures may escape detection until years later. osteoporosis causes a predisposition to more than 250. 1992]. wrists. hips or other bones
Up to 30% of patients suffering a hip fracture will require long term nursing home care.5% lifetime risk of fracture of the proximal femur [Melton et al.Therefore. In addition. you may have osteoporosis symptoms that include: Back pain. It is estimated that a 50-year-old white woman has a 17. 1997]. he or she is at very high risk of suffering another such fracture in the near future (next few years). with an accompanying stooped posture Fracture of the vertebrae.
Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture. The incidence of hip fractures increases each decade from the sixth through the ninth for both women and men for all populations. because osteoporosis doesn't cause symptoms unless bone fractures.000 hip fractures yearly [Ray et al. which can be severe if you have a fractured or collapsed vertebra Loss of height over time. But once bones have been weakened by osteoporosis. Then the symptoms are related to the location of the fractures. 1992].
d. patients may not be aware of their osteoporosis until they suffer a painful fracture.
You might not know you have it until you break a bone. the higher your risk of osteoporosis. Being a white or Asian woman-You're at greatest risk of osteoporosis if you're white or of Southeast Asian descent. having a parent or sibling with osteoporosis puts you at greater risk. Having osteopenia. This isn't true for women treated with tamoxifen.
Risk factors include : Getting older -The older you get. Your bones become weaker as you age. the cancer treatment drug methotrexate. Black and Hispanic men and women have a lower.
Breast cancer. which may reduce the risk of fractures.Women and men with anorexia nervosa or bulimia are at higher risk of lower bone density in their lower backs and hips. early bone loss and an increased risk of fractures. Low calcium intake contributes to poor bone density. which is low bone mass Eating disorders. A bone mineral density test is the best way to check your bone health. but still significant.e. Anyone can develop osteoporosis.
Osteoporosis is a silent disease. especially if you also have a family history of fractures. As many as half of all women and a quarter of men older than 50 will break a bone due to osteoporosis. especially if they were treated with chemotherapy or aromatase inhibitors such as anastrozole and letrozole. To keep bones strong. diuretics and aluminum-containing antacids also can cause bone loss.
. which suppress estrogen. Taking certain medicines-Long-term use of the blood-thinning medication heparin. risk. but it is common in older women. Factors
Osteoporosis makes your bones weak and more likely to break. For that reason. Having a family history of osteoporosis-Osteoporosis runs in families. Being small and thin -Men and women who are exceptionally thin or have small body frames tend to have higher risk because they may have less bone mass to draw from as they age.
Low calcium intake-A lifelong lack of calcium plays a major role in the development of osteoporosis.Postmenopausal women who have had breast cancer are at increased risk of osteoporosis. some anti-seizure medications.
The National Osteoporosis Foundation. They often occur in your spine or hips — bones that directly support your weight. Although most people do relatively well with modern surgical treatment. Hip fractures usually result from a fall. In some cases. you can lose several inches of height as your posture becomes stooped. uses very little radiation (less than one tenth to one hundredth the amount used on a standard chest x-ray). Unfortunately. medicines can also help.
. exercise and do not smoke. at least 30% of the bone has already been lost. the American Medical Association. hip fractures can result in disability and even death from postoperative complications. by the time x-rays can detect osteoporosis. especially in older adults. If needed. Compression fractures can cause severe pain and require a long recovery.
g. The test takes only 5 to 15 minutes to perform. x-rays are not accurate indicators of bone density. If you have many such fractures. formerly known as DEXA) for diagnosing osteoporosis. which appears much thinner and lighter than normal bones. The appearance of the bone on x-ray is often affected by variations in the degree of exposure of the x-ray film. and is quite precise. DXA measures bone density in the hip and the spine. In addition. spinal fractures can occur without any fall or injury simply because the bones in your back (vertebrae) become so weakened that they begin to compress. Wrist fractures from falls also are common. and other major medical organizations are recommending a dual energy x-ray absorptiometry scan (DXA. (National Institute of Arthritis and Musculoskeletal and Skin Diseases)
f. Complication Fractures are the most frequent and serious complication of osteoporosis.eat a diet rich in calcium and vitamin D. Diagnosis A routine x-ray can reveal osteoporosis of the bone.
Osteopenia (between normal and osteoporosis) is defined as bone density T score between –1 and –2. But because of
concerns about its safety and because other treatments are available. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture. Therefore. it is difficult to completely rebuild bone that has been weakened by osteoporosis." and it expresses the bone density in terms of the number of standard deviations (SD) below peak young adult bone mass. risedronate (Actonel). This score is called the "T score. calcitonin (Calcimar). prevention of osteoporosis is as important as treatment.5 SD or below.-
The bone density of the patient is then compared to the average peak bone density of young adults of same sex and race.5 SD. Osteoporosis treatment and prevention measures are:
Medications that stop bone loss and increase bone strength.
h. none of the available treatments for osteoporosis are complete cures. Most problems have been linked to certain oral types of HT. bone density testing is not appropriate if the person undergoing the test is not willing to take any treatment based on the results. such as alendronate (Fosamax). raloxifene (Evista). In addition. if bone density testing is done. either taken in combination with progestin or
The National Osteoporosis Foundation guidelines state that bone density testing does not need to be performed if a person has a known osteoporotic fracture because the condition will be treated with or without bone density results. Therefore. the role of hormone therapy in managing osteoporosis is changing. Osteoporosis is defined as bone density T score of –2.
Hormone therapy (HT) was once the mainstay of treatment for osteoporosis. and zoledronate (Reclast). it should be performed on people willing to take some specific action based on the results. Treatment And Medication
The goal of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength. ibandronate (Boniva).
In other words.
other forms are available. A new physical therapy program has been shown to significantly reduce back pain.
. The WKO is worn daily for 30 minutes in the morning and 30 minutes in the afternoon and while performing 10 repetitions of back extension exercises. creams and the vaginal ring. curtailing alcohol intake. The program combines the use of a device called a spinal weighted kypho-orthosis (WKO) — a harness with a light weight attached — and specific back extension exercises. improve posture and reduce the risk of falls in women with osteoporosis who also have curvature of the spine. and consuming a balanced diet with adequate calcium and vitamin D. exercising regularly. If you're interested in hormone therapy. Life style changes including quitting cigarette smoking.alone. including patches.
Swimming. Add soy to your diet. skipping rope. but you'll gain the most benefits if you start exercising regularly when you're young and continue to exercise throughout your life. Prevention
National Osteoporosis Foundation's Five Steps to Bone Health and Osteoporosis Prevention: Get your daily recommended amounts of calcium and vitamin D Engage in regular weight-bearing exercise Avoid smoking and excessive alcohol Talk to your healthcare provider about bone health When appropriate. Exercise can help you build strong bones and slow bone loss. stair climbing. Exercise will benefit your bones no matter when you start. Don't smoke. Hormone therapy can reduce a woman's risk of osteoporosis during and after menopause. perhaps by decreasing the amount of estrogen a woman's body makes and by reducing the absorption of calcium in your intestine. have a bone density test and take medicine. discuss the options with your doctor and decide what's best for you. The plant estrogens found in soy help maintain bone density and may reduce the risk of fractures. cycling and machines such as elliptical trainers can provide a good cardiovascular workout. they're not as helpful for improving bone health as weight-bearing exercises are.i. Combine strength training exercises with weight-bearing exercises. The effects on bone of secondhand smoke aren't yet known. running. but because they're low impact. But because of the risk of side effects. Testosterone replacement therapy works only for men with osteoporosis caused by low testosterone levels. jogging. Consider hormone therapy. hips and lower spine. Taking it when you have normal testosterone levels won't increase bone mass. Strength training helps strengthen muscles and bones in your arms and upper spine.
Other tips for prevention These measures also may help you prevent bone loss: Exercise. and weight-bearing exercises — such as walking. Smoking increases bone loss. skiing and impact-producing sports — mainly affect the bones in your legs.
Don't lean over while reading or doing handwork. the high-protein seeds of the soy plant.
Manage pain. high blood pressure.
Limit caffeine. memory problems. Moderate caffeine consumption — about two to three cups of coffee a day — won't harm you as long as your diet contains adequate calcium. a plant in the pea family. high cholesterol. Current uses of red clover are for menopausal symptoms. Like peas and beans. Maintain good posture. Consuming more than two alcoholic drinks a day may decrease bone formation and reduce your body's ability to absorb calcium. Good posture — which involves keeping your head held high. There's no clear link between moderate alcohol intake and osteoporosis. When you sit or drive. chin in. When lifting. shoulders back. keeping your upper back straight. place a rolled towel in the small of your back. and symptoms of prostate enlargement. not your waist. breast cancer. breast pain associated with menstrual cycles. Keep rooms brightly lit. Soybeans.
Avoid excessive alcohol. Left untreated. osteoporosis. It is found in modern American diets as a food or food additive.
Other therapy : Soy. menopausal symptoms such as hot flashes. Wear low-heeled shoes with nonslip soles and check your house for electrical cords. and lift with your legs. including high cholesterol levels. and prostate cancer. area rugs and slippery surfaces that might cause you to trip or fall. Discuss pain management strategies with your doctor. People use soy products to prevent or treat a variety of health conditions.
Prevent falls. it can limit your mobility and cause even more pain. Don't ignore chronic pain. osteoporosis. contain isoflavones-compounds similar to the female hormone estrogen. and make sure you can get in and out of your bed easily. has been common in Asian diets for thousands of years. The following information highlights what is known about soy when used by adults for health purposes. upper back flat and lower spine arched — helps you avoid stress on your spine. Red clover contains phytoestrogens—compounds similar to the female hormone estrogen. bend at your knees. install grab bars just inside and outside your shower door. red clover belongs to the family of plants called legumes.
which increases the risk for osteoporosis (a disorder characterized by porous. Calcium is needed for muscle contraction. A constant level of calcium is maintained in body fluid and tissues so that these vital body processes function efficiently. and sending messages through the nervous system . these processes are relatively equal. In early and middle adulthood. AIs meet or exceed the amount needed to maintain a nutritional state of adequacy in nearly all members
. the most abundant mineral in the human body. The balance between bone resorption and deposition changes as people age. Dietary Reference Intake (DRI) is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. the secretion of hormones and enzymes. muscle. weak bones)]. Adequate Intakes (AI). Three important types of reference values included in the DRIs are Recommended Dietary Allowances (RDA). has several important functions. Calcium: What is it?
Calcium. What is the recommended intake for calcium? Recommendations for calcium are provided in the Dietary Reference Intakes (DRIs) developed by the Institute of Medicine (IOM) of the National Academy of Sciences. particularly among postmenopausal women. During childhood there is a higher amount of bone formation and less breakdown. bone breakdown exceeds its formation. with constant resorption (breakdown of bone) and deposition of calcium into newly deposited bone (bone formation) .
B. More than 99% of total body calcium is stored in the bones and teeth where it functions to support their structure . The remaining 1% is found throughout the body in blood. The RDA recommends the average daily intake that is sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals in each age and gender group. An AI is set when there is insufficient scientific data available to establish a RDA. and Tolerable Upper Intake Levels (UL).PART 3 : CALCIUM INTAKE
A. and the fluid between cells. In aging adults. resulting in bone loss. blood vessel contraction and expansion.
Bone undergoes continuous remodeling.
is the maximum daily intake unlikely to result in adverse effects. Table 1: Recommended Adequate Intake by the IOM for Calcium Male and Female Age 0 to 6 months 7 to 12 months 1 to 3 years 4 to 8 years 9 to 13 years 14 to 18 years 19 to 50 years 51+ years 210 270 500 800 1300 1300 1000 1200 Calcium (mg/day) N/A N/A N/A N/A N/A 1300 1000 N/A Pregnancy & Lactation
There is a widespread concern that Americans are not meeting the recommended intake for calcium. Table 1 contains the current recommendations for calcium for infants. the following percentage of Americans are not meeting their recommended intake for calcium : 44% boys and 58% girls ages 6-11 64% boys and 87% girls ages 12-19 55% men and 78% of women ages 20+
. For calcium. It is listed in the section "Is there health risk of too much calcium?" of this fact sheet. According to the Continuing Survey of Food Intakes of Individuals (CSFII 1994-96). children and adults. The UL.of a specific age and gender group. the recommended intake is listed as an Adequate Intake (AI). which is a recommended average intake level based on observed or experimentally determined levels. on the other hand.
in the institutionalized. include sunlight.25-Dihydroxy vitamin D. 1. Unique host characteristics may also modify the effects of dietary calcium on bone health. the presence of gastrointestinal disorders such as malabsorption and the postgastrectomy syndrome. These include the individual's age and ethnic and genetic background. stimulates active transport of calcium in the small intestine and colon. hormones. drugs. less than 10 percent of dietary calcium may be absorbed. besides supplements. Sufficient vitamin D should be ensured for all individuals. vitamin D-fortified liquid dairy products. Vitamin D deficiency is associated with an increased risk of fractures. impaired activation of vitamin D. and in the elderly.25-dihydroxy vitamin D. Interactions among these diverse cofactors may affect calcium balance in either a positive or negative manner and thus alter the optimal levels of calcium intake. which is normally the major stimulus for endogenous vitamin D synthesis. Calcium and vitamin D need not be taken together to be effective. and the presence of liver and renal disease. especially the elderly who are at greater risk for development of a deficiency. Vitamin D metabolites enhance calcium absorption. Excessive doses of vitamin D may introduce risks such as hypercalciuria and hypercalcemia and should be avoided. Supplementation of vitamin D intake to provide 600-800 IU/day has been shown to improve calcium balance and reduce fracture risk in these individuals. What Are the Important Cofactors for Achieving Optimal Calcium Intake?
Several cofactors modify calcium balance and influence bone mass. In the absence of 1.C. and fatty fish. This is especially evident in homebound or institutionalized individuals.
. and inadequate sunlight exposure. cod liver oil. caused by inadequate dietary vitamin D.25-dihydroxy vitamin D. Elderly patients are at particular risk for vitamin D deficiency because of insufficient vitamin D intake from their diet. results in reduced calcium absorption. Sources of vitamin D. inadequate exposure to sunlight. These include dietary constituents. and the level of physical activity. Deficiency of 1. the major metabolite. particularly in certain disorders. impaired renal synthesis of 1. or acquired resistance to vitamin D.25-dihydroxy vitamin D. Anticonvulsant medications may alter both vitamin D and bone mineral metabolism.
1 cup (8 fl oz) of milk .In the United States (U. Thus far. the positive effects of exercise on skeletal health are not likely to be related to calcium intake. and parathyroid hormone. studies of elderly individuals and perimenopausal women have failed to establish a positive interaction between calcium intake and exercise to increase bone mass. The U. D. other endogenous cofactors that could enhance net calcium absorption include growth hormone. A serving is equal to: . An interrelationship between physical activity and calcium balance has not been established conclusively. Sex hormone deficiency is associated with excessive bone resorption in women and men. Therefore.8 oz of yogurt . Department of Agriculture's Food Guide Pyramid recommends that individuals two years and older eat 2-3 servings of dairy products per day. However.S.). One study suggested that calcium supplementation can decrease the minimum estrogen dosage required to maintain bone mass in postmenopausal women.0 oz of processed cheese (such as American)
.2.Although symptomatic skeletal disease is uncommon in noninstitutionalized settings. In a single study. Low calcium intake can exacerbate the deleterious consequences of sex hormone deficiency. The inadequate intake of dairy foods may explain why some Americans are deficient in calcium since dairy foods are the major source of calcium in the diet . yogurt and cheese are the major contributors of calcium in the typical diet .5 oz of natural cheese (such as Cheddar) . increased physical activity enhanced the beneficial effect of oral calcium supplementation on bone mass in young adults.S. milk. What foods provide calcium? . In addition to estrogen.1. insulin-like growth factor-I. oral calcium alone does not prevent the postmenopausal bone loss resulting from estrogen deficiency. optimal calcium intake is advised for persons using anticonvulsants.
25% milk fat). Milk. canned. made w/calcium sulfate. 6 fl oz. soft serve. Pudding. pink. 8 fl oz. 1 cup Calcium (mg) 415 245-384 324 306 302 297 291 285 285-302 275 204 200-260 181 153 138 138 120 105-250 103 100-1000 % DV* 42% 25%-38% 32% 31% 30% 30% 29% 29% 29-30% 28% 20% 20-26% 18% 15% 14% 14% 12% 10-25% 10% 10%23
. Cheddar cheese. Yogurt. cooked. no solids. 8 fl oz. ½ cup Cottage cheese. soft. Sardines. low fat. 8 fl oz Milk. lactose reduced. with bones. solids with bone.Figure 1: Calcium Content of 8 fl oz of Milk Compared to Other Food Sources of Calcium
Source:  Table 2: Selected Food Sources of Calcium [6-8] Food Yogurt. 1% milk fat. 8 fl oz. instant. Salmon. made w/calcium sulfate. 1 ½ oz shredded Milk. made w/ 2% milk. Milk. 3 oz. 8 oz. low fat. ½ cup*** Orange juice. canned in oil. various flavors and brands. calcium fortified. calcium fortified. part skim 1 ½ oz. powder prepared with water. buttermilk. ½ cup Ready to eat cereal. 3 oz. Tofu. Milk. 8 fl oz. 1 cup unpacked Tofu. chocolate. 8 oz. vanilla. ½ cup*** Spinach. whole (3. 8 fl oz. plain. non-fat.** Mozzarella. firm. Frozen yogurt. ½ cup Instant breakfast drink. reduced fat (2% milk fat). fruit.
flour. raw.S. 99 94 90 85 80-500 74 42 37 32 31 21 20 12 10% 9% 9% 8. raw. 1 cup Kale. ready to bake/fry. corn. calcium fortified. 2 Tbsp Bread. cultured. ½ cup Kale. 1 slice Cheese. 1 oz Broccoli. For foods not listed in this table. Department of Agriculture's Nutrient. if you consumed a food that contained 300 mg of calcium. raw. the DV would be 30% for calcium on the food label. The DV for calcium is based on 1000 mg. 1 cup Ice cream. cooked.100% Turnip greens.5% 8-50% 7% 4% 4% 3% 3% 2% 2% 1%
A food providing 5% of the DV or less is a low source while a food that provides 10-19% of the DV is a good source and a food that provides 20% of the DV or more is an excellent source for a nutrient. regular. 1 Tbsp *DV=Daily Value **Content varies slightly according to fat content. boiled. For instance. white. average =300 mg calcium *** Calcium values are only for tofu processed with a calcium salt. one 6" diameter Sour cream. ½ cup Bread. cream. 8 fl oz.
. Daily Values (DV) were developed to help consumers determine if a typical serving of a food contains a lot or a little of a specific nutrient. please refer to the U. 1 medium Tortilla. whole wheat. Tofu processed with a non-calcium salt will not contain significant amounts of calcium. ready to bake/fry. vanilla. The percent DV (% DV) listed on the Nutrition Facts panel of food labels tells you what percentages of the DV are provided in one serving. ½ cup Soy beverage. reduced fat. Chinese cabbage. 1 cup Tortilla.
Weight bearing exercise is the type of exercise that causes your bones and muscles to work against gravity while they bear your weight. Bones continue to add more mass until around age 30. childhood. wrist.
Osteoporosis and osteopenia can result from dietary factors such as : chronically low calcium intake low vitamin D intake poor calcium absorption excess calcium excretion
. or low bone mass. ribs. it is particularly important to consume adequate calcium and vitamin D throughout infancy. During childhood and adolescence. bones increase in size and mass. Therefore. Because bone loss. vertebrae. pelvis. fragile bones. Examples of weight bearing exercise walking running dancing aerobics Examples of NON-weight bearing exercise swimming bicycling water aerobics skating
Osteoporosis is a disorder characterized by porous.5 million fractures because of osteoporosis . is a gradual process. It is a serious public health problem for more than 10 million Americans. the stronger your bones are at age 30.PART 4 : CORRELATION BETWEEN OSTEOPOROSIS AND CALCIUM INTAKE
Calcium and bone health Your bones are living tissues and continue to change throughout life. like bone growth. Each year. Peak bone mass is the point when the maximum amount of bone is achieved. Another 34 million Americans have osteopenia. which precedes osteoporosis. It is also important to engage in weight-bearing exercise to maximize bone strength and bone density (amount of bone tissue in a certain volume of bone) to help prevent osteoporosis later in life. Americans suffer from 1. when peak bone mass is reached. and other bones . 80% of whom are women. the more your bone loss will be delayed as you age. Osteoporosis is a concern because of its association with fractures of the hip. and adolescence. Resistance exercises such as weight training are also important because they help to improve muscle mass and bone strength.
The claim states that "adequate calcium intake throughout life is linked to reduced risk of osteoporosis through the mechanism of optimizing peak bone mass during adolescence and early adulthood and decreasing bone loss later in life". Bone loss also occurs as a part of the aging process.
These factors include being female. wrist.0 to -2.
In 1993 the FDA authorized a health claim for food labels on calcium and osteoporosis in response to scientific evidence that an inadequate calcium intake is one factor that can lead to low peak bone mass and is considered a risk factor for osteoporosis . finger. excessive intake of alcohol. bone breakdown occurs because the body must use the calcium stored in bones to maintain normal biological functions such as nerve and muscle function. shin bone.-
When calcium intake is low or calcium is poorly absorbed. cigarette smoking.0 and above indicates normal bone density. A score below -2. Researchers have identified many factors that increase the risk for developing osteoporosis.
Various bone mineral density (BMD) tests.5 indicates that a person is considered to have low bone mass (osteopenia). of advanced age. inactive. including those that measure your hip.
See Figure 2 below. A T-score of -1.5 indicates osteoporosis. can help determine bone mass. These tests provide a Tscore which is a measure of bone mineral density that compares an individual's BMD to an optimal BMD of a 30 year old healthy adult. and heel. and having a family history of osteoporosis . A T-Score of -1. spine. thin.
A prime example is the loss of bone mass observed in post-menopausal women because of decreased amounts of the hormone estrogen.
well below the minimum intake (for women) of 1. one of the health minister's advisers. Calcium is found in dairy products such as milk.
Indonesian men are also susceptible to brittle bones as they consume only 300 grams of calcium per day on average. Adequate calcium and vitamin D intakes.
Recent research from the Health Ministry found that one in three Indonesian women aged
50 years and above are prone to osteoporosis due to insufficient calcium intake during
their childhood.000 grams. The research also showed that Indonesian women in West Jakarta consume 244 grams of calcium per day on average. eggs.-
Figure 2: Interpreting Bone Mineral Density Scores
Although osteoporosis affects people of different races. said that as the first symptoms of the disease usually did not appear until the advanced stages. as well as weight bearing exercise are critical to the development and maintenance of healthy bone throughout the lifecycle. Older adults should strive to maintain recommended daily calcium intakes as well as an adequate vitamin D intake.
Richard Panjaitan. Most people have heard of osteoporosis but mistakenly associate it exclusively with elderly women.
. genders and ethnicities. women are at highest risk because their skeletons are smaller to start with and because of the accelerated bone loss that accompanies menopause.and cheese as well as vegetables and fruits. it was important to detect it as early as possible.
TABLE 4 : Calsium and other minerals intake among 50 years old women in Weat jakarta in 2008
Preventing new fractures is the basic goal of osteoporosis treatment.
Osteoporosis is not a debilitating disease if one starts on the prevention protocol quickly.
The best strategy for maintaining healthy bones would appear to be adequate calcium consumption from the diet and supplements taken at mealtime if necessary. and adequate calcium and vitamin D are important steps that everybody can take to improve their bone strength. the time when bone loss starts to become significant.
Osteoporosis is an epidemic problem that can be stopped if you just start to work on it today. It is also the most widely used supplement. too. Exercise. contains the highest amount of elemental calcium of all supplements and is moderately priced. The bone density findings provide valuable clues but the real reason for treatment is to prevent fractures. one that is high in alkaline and base is preferred to an acidic body causes minerals to be bleached out of the bones in most cases. From a diet perspective.Summary of osteoporosis
Osteoporosis is a common problem that can respond to treatment and prevention. you improve your body’s response to the aging process. Estrogen deficiency is the most common cause of osteoporosis. Realize that every year you work on building bone density. and therefore is an excellent choice as a supplement.
Calcium carbonate achieves maximum absorption when taken with meals. as early as age 35. Osteoporosis affects men.PART 5 : CONCLUSION . healthy diet.
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